# Pregnancy in women with congenital physical disabilities: Risk factors, birth outcomes, and mediation

> **NIH NIH R03** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2020 · $82,500

## Abstract

The average lifespan of individuals born with most congenital malformations has vastly improved in the past
decades, allowing the majority to survive through the reproductive years. Because the presence of a physical
disability typically does not affect fertility or the desire for a family, it is important to understand the course of
pregnancy among affected women. Evidence shows that women with varying definitions of disability are more
likely to have babies born with low birth weights or prematurely. The limited research available suggests that
relevant risk factors for these birth outcomes tend to be more common in pregnant women with varying
disabilities compare to the general population. For example, cigarette smoking, alcohol drinking, and obesity
increase risks of adverse outcomes and appear to be disproportionately higher in pregnant women with
disabilities. However no study to date has examined pregnancy exposures in relation to adverse birth
outcomes among women with physical disabilities. In women of childbearing ages, physical disabilities most
often stem from congenital muscular and neuromuscular defects (cMND), defined as spina bifida, cerebral
palsy, muscular dystrophy, and limb anomalies (contractures, missing or shortened). Impairments in mobility
and dexterity can impact activities of daily living and result in chronic pain, sleep disturbances, and
psychosocial problems. Medications needed for the treatment of these symptoms, and other behavioral coping
mechanisms, may be associated with birth outcomes, raising further the need to study the course of pregnancy
and birth outcomes among cMND-affected women. This study will take advantage of rich data resource - the
Boston University Slone Epidemiology Center Birth Defects Study. From 1976 to 2015, over 68,000 mothers
of babies born with and without congenital anomalies were asked detailed questions about a range of events
and exposures during pregnancy for the purpose of identifying risk factors for birth defects. Women were
specifically asked if they were born with spina bifida or any anomalies of the brain, head, spine, spinal cord,
muscles, bones, arms, or legs. This study will compare the 132 women who were identified as having a
cMND to 528 unaffected women for the following pregnancy exposures: cigarette smoking, alcohol intake, pre-
pregnancy body mass index, vitamin supplementation, kidney/bladder infection, pain medications, sleep
medications, and psychoactive medications. Comparisons of common adverse birth outcomes will include
premature birth, low birth weight, and macrosomia. In addition, mediation analyses will measure the amount of
an association between cMND and birth outcomes that is mediated through pregnancy exposures. An
estimated 212,000 US women of childbearing ages have a cMND, for whom pregnancy may require special
services. It is necessary to understand the course of pregnancy and outcomes among women with congenital
physical disabilities as a step toward ...

## Key facts

- **NIH application ID:** 9883035
- **Project number:** 5R03HD098507-02
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** MARTHA M. WERLER
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $82,500
- **Award type:** 5
- **Project period:** 2019-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9883035

## Citation

> US National Institutes of Health, RePORTER application 9883035, Pregnancy in women with congenital physical disabilities: Risk factors, birth outcomes, and mediation (5R03HD098507-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/9883035. Licensed CC0.

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